Methodist Charlton Medical Center
3500 W Wheatland Road, Dallas, TX · Methodisthealthsystem · · NPI 1275592131
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Culture fungi definitive id yeast CPT 87106 | $188.00 | $376.00 | $8.24 – $35.48 | 61 |
| Culture fungi other (except blood) CPT 87102 | $186.00 | $372.00 | $6.71 – $28.89 | 61 |
| Culture fungi skin/hair/nail CPT 87101 | $186.00 | $372.00 | $6.16 – $26.52 | 61 |
| Culture mycoplasma any source CPT 87109 | $18.00 | $36.00 | $12.28 – $52.91 | 61 |
| Culture quantitative aerobic other source CPT 87071 | $201.00 | $402.00 | $7.89 – $34.00 | 61 |
| Culture screening strep group a CPT 87081 | $101.00 | $202.00 | $5.29 – $22.79 | 61 |
| Culture typing added method CPT 87158 | $54.00 | $108.00 | $6.18 – $26.60 | 61 |
| Culture typing immunologic CPT 87147 | $195.50 | $391.00 | $4.13 – $17.80 | 61 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $165.00 | $330.00 | $28.01 – $120.63 | 61 |
| Culture urine each isolate CPT 87088 | $43.00 | $86.00 | $6.46 – $27.83 | 61 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $13.12 | $26.25 | $8.25 – $8.25 | 1 |
| Cyclic citrullinated peptide antibody CPT 86200 | $12.00 | $24.00 | $10.34 – $44.52 | 61 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $826.00 | $1,652.00 | $0.59 – $245.36 | 55 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $14.37 | $28.75 | $11.59 – $11.59 | 1 |
| Cyclosporine 2 hour CPT 80158 | $711.00 | $1,422.00 | $14.40 – $62.03 | 61 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $5.75 | $11.50 | $1.89 – $1.89 | 1 |
| Cygnus matrix, per sq cm HCPCS Q4199 | $60.94 | $121.88 | $6.04 – $330.14 | 55 |
| Cyp2c19 gene com variants CPT 81225 | $169.00 | $338.00 | $232.50 – $1,001.48 | 61 |
| Cyp2c9 gene com variants CPT 81227 | $60.00 | $120.00 | $139.50 – $600.87 | 61 |
| Cyp3a4 gene common variants CPT 81230 | $240.00 | $480.00 | $174.81 – $471.99 | 57 |
| Cystatin c CPT 82610 | $55.50 | $111.00 | $14.78 – $63.67 | 61 |
| Cystic fibrosis cftr CPT 81223 | $900.00 | $1,800.00 | $398.20 – $1,715.20 | 61 |
| Cystine urine quantitative CPT 82131 | $12.50 | $25.00 | $18.34 – $78.98 | 61 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $536.00 | $1,072.00 | $39.37 – $925.52 | 60 |
| Cystometrogram w/up 51727 CPT 51727 | $774.00 | $1,548.00 | $685.13 – $1,849.85 | 56 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $93.75 | $187.50 | $31.55 – $31.55 | 1 |
| Cytogenetics 25-99 CPT 88274 | $78.00 | $156.00 | $33.82 – $145.68 | 61 |
| Cytogenomic neo microra alys CPT 81277 | $1,050.00 | $2,100.00 | $1,160.00 – $3,132.00 | 57 |
| Cytogenom microarray copy nmbr var CPT 81228 | $971.50 | $1,943.00 | $900.00 – $2,430.00 | 57 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $103.00 | $206.00 | $11.49 – $49.47 | 61 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $84.50 | $169.00 | $13.44 – $57.90 | 61 |
| Cyto/molecular report CPT 88291 | $346.00 | $692.00 | $25.91 – $111.59 | 61 |
| Cytopath c/v auto in fluid CPT 88174 | $24.50 | $49.00 | $20.24 – $87.20 | 61 |
| Cytopath c/v thin layer redo CPT 88143 | $32.50 | $65.00 | $18.38 – $79.18 | 61 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $99.00 | $198.00 | $51.20 – $222.03 | 61 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $66.00 | $132.00 | $21.23 – $91.46 | 61 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $32.50 | $65.00 | $16.17 – $69.65 | 61 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $247.50 | $495.00 | $36.70 – $229.68 | 61 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $117.50 | $235.00 | $36.70 – $262.50 | 61 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $447.50 | $895.00 | $11.39 – $97.35 | 5 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $447.50 | $895.00 | $42.77 – $451.97 | 61 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $406.00 | $812.00 | $51.20 – $562.20 | 61 |
| Cytopath smear oth prep screen & interp CPT 88161 | $124.00 | $248.00 | $28.42 – $275.64 | 61 |
| Cytopath tbs c/v manual CPT 88164 | $9.50 | $19.00 | $12.73 – $61.05 | 61 |
| Cytotoxic antibody screening CPT 86807 | $166.50 | $333.00 | $62.77 – $270.36 | 61 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $345.00 | $690.00 | $167.40 – $1,330.06 | 61 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $2,241.75 | $4,483.50 | $15.59 – $3,668.65 | 55 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $775.00 | $1,550.00 | $669.20 – $669.20 | 1 |
| Dch pulmonary stress test CPT 94621 | $984.50 | $1,969.00 | $71.96 – $989.94 | 57 |
| Dch validity tests CPT 81002 | $43.00 | $86.00 | $2.77 – $11.95 | 61 |
| Deamidated gliadin antibody iga CPT 86258 | $10.50 | $21.00 | $9.61 – $41.41 | 60 |
| Debridement (>20 cm) charge pt CPT 97598 | $483.50 | $967.00 | $17.36 – $17.36 | 1 |
| Decalcification CPT 88311 | $292.00 | $584.00 | $14.24 – $66.74 | 5 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $39.62 | $79.25 | $34.03 – $34.03 | 1 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $148.50 | $297.00 | $167.05 – $580.92 | 57 |
| Dermapure 1 square cm HCPCS Q4152 | $185.62 | $371.25 | $122.27 – $330.14 | 54 |
| Design mlc device for imrt CPT 77338 | $3,679.50 | $7,359.00 | $367.90 – $993.32 | 57 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $79.87 | $159.75 | $20.65 – $20.65 | 1 |
| Desoxycorticosterone CPT 82633 | $80.00 | $160.00 | $24.72 – $106.47 | 61 |
| Detect agent nos dna dir CPT 87797 | $153.00 | $306.00 | $23.97 – $103.24 | 61 |
| Developmental screen/score/document 96110 CPT 96110 | $411.50 | $823.00 | $22.06 – $22.06 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | $432.50 | $865.00 | $91.31 – $91.31 | 1 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $1,521.00 | $3,042.00 | $7.07 – $7.07 | 1 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $217.00 | $434.00 | $56.13 – $56.13 | 1 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $7.50 | $15.00 | $0.19 – $0.19 | 1 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $16.50 | $33.00 | $17.74 – $76.40 | 61 |
| Diabetes (HbA1c) Test CPT 83036 | $79.00 | $158.00 | $7.75 – $33.39 | 61 |
| Diab manage trn ind/group HCPCS G0109 | $87.50 | $175.00 | $16.03 – $66.15 | 57 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $135.00 | $270.00 | $12.64 – $158.96 | 28 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $74.00 | $148.00 | $12.64 – $158.96 | 28 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $580.00 | $1,160.00 | $110.02 – $297.05 | 57 |
| Diagnostic Mammogram (one breast) CPT 77065 | $469.00 | $938.00 | $85.78 – $231.61 | 57 |
| Dialysis one evaluation CPT 90945 | $3,632.50 | $7,265.00 | $409.98 – $1,106.95 | 56 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $50.37 | $100.75 | $53.78 – $53.78 | 1 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $51.75 | $103.50 | $29.64 – $29.64 | 1 |
| Dicyclomine injection HCPCS J0500 | $51.75 | $103.50 | $67.11 – $67.11 | 1 |
| Diffusing capacity CPT 94729 | $415.50 | $831.00 | $91.31 – $91.31 | 1 |
| Digital analysis of eeg CPT 95957 | $521.50 | $1,043.00 | $145.33 – $145.33 | 1 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $10.25 | $20.50 | $9.08 – $9.08 | 1 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $6,267.25 | $12,534.50 | $5,166.99 – $13,950.88 | 55 |
| Digoxin total therapeutic drug level CPT 80162 | $292.00 | $584.00 | $10.60 – $45.67 | 61 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $919.50 | $1,839.00 | $749.23 – $2,022.93 | 55 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $3.00 | $6.00 | $1.65 – $1.65 | 1 |
| Disaccharidases CPT 82657 | $499.50 | $999.00 | $17.69 – $76.19 | 61 |
| Discography cerv/thor spine CPT 72285 | $1,718.00 | $3,436.00 | $125.69 – $5,180.36 | 60 |
| Dmpk gene detc abnor allele CPT 81234 | $292.50 | $585.00 | $137.00 – $369.90 | 57 |
| Dna antibody native/double stranded CPT 86225 | $63.50 | $127.00 | $10.96 – $47.22 | 61 |
| Dna gardnerella CPT 87510 | $16.00 | $32.00 | $16.00 – $68.91 | 61 |
| Dna trichomonas CPT 87660 | $16.00 | $32.00 | $16.00 – $68.91 | 61 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $43.75 | $87.50 | $6.81 – $6.81 | 1 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $209.12 | $418.25 | $462.70 – $462.70 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $41.62 | $83.25 | $2.39 – $2.39 | 1 |
| Doppler echo complete CPT 93320 | $690.50 | $1,381.00 | $22.60 – $22.60 | 1 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $643.00 | $1,286.00 | $651.79 – $651.79 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $2,459.00 | $4,918.00 | $69.69 – $572.82 | 60 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $654.00 | $1,308.00 | $111.55 – $352.96 | 57 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $540.25 | $1,080.50 | $41.71 – $41.71 | 1 |
| Dpyd gene common variants CPT 81232 | $232.50 | $465.00 | $174.81 – $471.99 | 57 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $22.37 | $44.75 | $3.99 – $3.99 | 1 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $11.75 | $23.50 | $3.68 – $330.14 | 55 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.